Organization
SIKESTON REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY DAVIED P.T. (P.T./OWNER)
(573) 471-0110
Entity
Organization
Contact information
Practice address
806 S. KINGSHIGHWAY, SIKESTON, MO 63801
(573) 471-0110
(573) 472-1880
Mailing address
806 S. KINGSHIGHWAY, SIKESTON, MO 63801
(573) 471-0110
(573) 472-1880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
000224
MO
225100000X
Physical Therapist
Primary
111613
MO
225100000X
Physical Therapist
2008022311
MO
225100000X
Physical Therapist
2012023604
MO
225200000X
Physical Therapy Assistant
119750
MO
225X00000X
Occupational Therapist
004781
MO
Other
Enumeration date
03/26/2009
Last updated
05/09/2013
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